Tier Registration Form

Harambee House of Wellness

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Tier Registration

Registration Form

Tier Registration

* Indicates required field

Name *

First

Last

Email *

Preferred Name *

Phone Number *

Have you had your alignment call? *

Yes, I have had my alignment Call No, I have not

Have you had your assessment session? *

Yes, I have done my assessment. No, I need to schedule my assessment. Special Permission (Spoke with practitioner)

Why do you feel called to these services? *

You will receive an invoice for payments, but please let us know your preferred method. *

Zelle (Preferred) 678-933-1386 Venmo @Shanika-Purnell Cash (Preferred) (Established Clients Only) Credit/Debit card CashApp $sunshyneislove Paypal (Please add PP Fees)

City & State *

Tier Selection *

Tier 1: Awakening ($129 monthly) Tier 2: Activation ($229 monthly) Tier 3: Ascension ($349 monthly)

Please know that each person's journey will be personalize after assessment has been done. Your sessions may include: reiki, life coaching, sound healing, ceremonies and a host of other modalities based off of the assessment findings. Is this understood? *

Yes, I understand No, I need more explanation

Do you have any questions? *

HOW DID YOU HEAR ABOUT US? Let us know if someone referred you. *

I agree to receiving marketing and promotional materials *

Submit Registration

"Where spirit meets community."

Home
About
Rates & Services NEW!
Contact
- Testimonials